With the boom of the electronic age and machines to do almost all work, physical activity has become a thing of the past. This in turn has led to a large increase in obesity and problems related to it. One of the most common concerns is arthritis of the knee and other deformities that are related to weight bearing in the knee joints.
This in turn leads to an increase in the number of knee replacements that we see every year. It should be noted here that most orthopaedics agree that physiotherapy has completely changed the way patients deal with knee replacements.
We are now looking at shorter recovery periods, increased strength and endurance of the patient after a knee replacement and a completely different life expectancy post-surgery. All of this is only possible if patients are given quality physiotherapy that prepares them for a better tomorrow.
Phases of Physical Therapy After Total Knee Replacement
Most physical therapists categorise post-knee surgery patients into the following three categories:
Day 1 – 3 after surgery:
This stage begins immediately after surgery. The patient needs to begin quadriceps strengthening as well as generalised strengthening exercises for the thigh. The patient must also be encouraged to perform range of motion exercises, within their pain limits. It is advised to let the patient get familiar with the exercises in this stage as he may be suffering from a lot of inhibitions due to pain.
Week 2 – 3
In this stage, the patient has already been discharged and must continue his exercises at home or at a physical therapy rehabilitation clinic. It is important to increase strengthening exercises of the thigh and knee. The patient should also begin practising balance exercises and gait training. It is a good idea to expose the patient to a range of walking terrains during this phase to ensure that he develops the skills necessary for modulating his gait.
Upto 4 months of surgery
This is one of the most important phases of recovery. Sadly, it is also the most ignored. Patients must continue strength training. Walking must be increased and the difficulty level must be escalated in this phase. This can be done easily, by encouraging the patient to walk on inclined planes at varying speeds. In addition, patients must focus on their cardiovascular endurance during this stage. This will help the recovery of the patient to “normal”.
Keep In Mind
Listed below are a few pointers that both patients and physical therapists must keep in mind after a total knee replacement surgery.
Every patient is different and so is the progression back to daily life. It is imperative to understand that all patients react to pain differently and might have varying levels of progression after surgery.
Strength training is the key to happy knees. Though it is painful and difficult, it is something that all patients must go through. Patients to should be encouraged to reach their pain thresholds on a regular basis to improve their strength.
Do not depend only on your therapist, and make sure that you practice the exercises by yourselves at home. An increased number of repetitions obviously means stronger knees that are less prone to repeated injuries.
Do not overdo it. This might seem like a contradiction after looking at the previous point, but it is important to know your thresholds and not do anything that places unnecessary stress on your knees.
Begin exercising even before the surgery. The last point is slightly controversial as it might not always be possible to adhere to it. However, if you have been suffering from knee pain for a while and are aware that you will be scheduled for a TKR in the near future, it is best to begin quadriceps strengthening in the beginning itself as you can have your thigh muscles in the best shape possible for recovery after surgery.